Summary of Coverage 2017-2018

The Northwestern University Student Health Insurance Plan (NU-SHIP) complies with all Patient Protection and Affordable Care Act (ACA) requirements for student health insurance plans. There are no exclusions for pre-existing conditions for this plan.

The plan year runs September 1–August 31. Annual benefits apply to services received during this period of time.

NU-SHIP: What's Covered at a Glance

Type

Description

Preferred Care (In-Network Provider)

Non-Preferred Care (Out-of-Network Provider)

Plan Deductible

Amount you pay for medical costs, before NU-SHIP begins to pay for covered services.

$ 250

$ 250

Annual Out-of-Pocket Limit

Amount you pay out of pocket before NU-SHIP pays 100% for covered health benefits, subject to any benefit maximums or limits that may apply. (Applicable co-pays and deductibles will be applied to out-of-pocket maximum.)

$ 1,300 (individual) / $2,600 (family)

None (you are encouraged to use only in-network providers)

Co-insurance

The percentage of covered medical expenses that you are responsible for.

see below

see below

Co-payment

Specified dollar amount you pay for certain covered medical expenses.

see below

see below

Inpatient/Outpatient Medical Expenses

See Plan Guide for details

80% of negotiated charge

60% of negotiated charge

Physician Office Visit

Note: $50 penalty incurred without referral from NUHS

80% of negotiated charge

After $20 co-pay per visit, 60% of recognized charge

Outpatient Mental Health

After $20 co-pay per visit, 100% of negotiated charge

After $20 co-pay per visit, 100% of recognized charge

Emergency Room

80% of negotiated charge

80% of recognized charge

Prescription Drugs

Each prescription fill:
$10 co-pay – generic
$40 co-pay – brand

Deductible per supply of 50% of recognized charge

Routine Physical Exam

Includes routine vision and hearing screenings given as part of the routine physical exam